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Parent Consent Form

This document is a parental consent form for Edgardo B. Siapco Jr., a 4th year criminal justice student, to participate in an off-campus activity from September 5 to December 10, 2021. The activity will take place at locations like the NBI, PDEA, BJMP, BFP, PNP, and two barangays. The parent, Gina B. Siapco, gives full consent and approval for her son to attend and assures he will act responsibly. She is aware the university will take safety precautions but is not liable for uncontrollable incidents. The form was signed on September 5, 2021.

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577 views

Parent Consent Form

This document is a parental consent form for Edgardo B. Siapco Jr., a 4th year criminal justice student, to participate in an off-campus activity from September 5 to December 10, 2021. The activity will take place at locations like the NBI, PDEA, BJMP, BFP, PNP, and two barangays. The parent, Gina B. Siapco, gives full consent and approval for her son to attend and assures he will act responsibly. She is aware the university will take safety precautions but is not liable for uncontrollable incidents. The form was signed on September 5, 2021.

Uploaded by

mica
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ACADEMIC PLANNING & SERVICES

[ / ] Main [ ] Branch _________________


PARENTAL/GUARDIAN CONSENT

I, parent/guardian of ________Edgardo B. Siapco Jr. ____________ , a ___ 4th_____ year student of the
Name of Student
__Criminal Justice Education ____ give my full consent and approval for him/her College and Program to attend and
participate in an official off-campus activity of the University of Mindanao (please check one category only):

A. Curricular (Disciplinal)
[ ] Education tours and field trips [ ] Research field work/data gathering
[/] Local [ ] International [ ] Work immersion (SHS) / Immersion (CHE)
[ ] Practicum, internship and OJT [ ] Externship
[ ] National [ ] Abroad [ ] NSTP (CWTS, ROTC, LTS)
[ ] RLE (nursing/midwifery programs) [ ] Seminars, trainings or conferences
[ ] FS (teacher education programs) [ ] Competitions and contests
[ ] Student exchange/fellowship [ ] Club Activities
[ ] Academic [ ] Industry [ ] Event invitations
[ ] Community extension/outreach work [ ] Others (please specify): ____________________

B. Non-Curricular (Non-Disciplinal)
[ ] Community Outreach [ ] Seminars, trainings or conferences
[ ] Competitions and contests [ ] Event invitations
[ ] Club activities [ ] Others (please specify): ____________________

I am granting permission to my son/daughter/ward to attend the said activity in

_NBI, PDEA, BJMP, BFP, PNP, Barangay Maa and Barangay 76-A__ on _September 5- December 10, 2021_
Identify the place/venue of the of -campus activity Dates/period of activity

I assure that my son/daughter/ward shall act responsibly and follow all the university rules and regulations pertinent to this
activity.

I am fully aware that the University of Mindanao shall take all the necessary safety measures and precautions to keep my
son/daughter/ward safe and secure, and shall ensure that all requirements for the said activity are complied with.

If untoward incidents occur beyond the control of the university, despite all the efforts taken and the exercise of due diligence
effectively established, I waive and release the University of Mindanao, its officers, faculty and personnel, from liability.
Accordingly, I shall fully cooperate with the University of Mindanao for the resolution of any untoward and uncontrollable
events.

I duly affix my signature as stamp of my consent in good faith, without fraud and deceit, as I am fully aware of my
accord and accountability as consenting parent/guardian.

__________Gina B. Siapco ____________ September 5, 2021


Full name and signature of parent/guardian Date

Duly checked, verified and signed: _____Eduardo C. Berco___ September 5, 2021


Faculty-in charge/Head of Office Date

REMINDER: For review and approval by the appropriate level of authority

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